An old HS friend used to call me Joyful and I've tried to live up to that. It's not too hard, with my family always here to keep me smiling. I am definitely blessed.
Psst - I'm an actuary and I will comment on public policy from time to time. Just want to make it clear that views expressed here are my own, and not those of the company I work for.

Monday, October 27, 2008

My thoughts on health care

As promised, here are my thoughts on the health care issue.

Many years ago, I was a staunch believer in personal responsibility where health care and health insurance are concerned. I reasoned that it is not right for a person to go along through life, "self insuring" as long as she or he is young and healthy, and then suddenly expect others to pay her or his way once the first signs of aging and disease begin. I still believe that.

However, the more I study this issue, the more I have come to realize that there is a whole segment of the American public -- many of whom WORK for a living and just scrape by -- for whom the concept of health insurance doesn't work. They simply can't afford it. And I'm not talking about only those people whose income is below that artificial line that we officially call "poverty". I'm talking about people who feel that they can choose to buy food or insurance. They can buy secondhand clothes and shoes for their kids, or they can buy insurance. I believe I have a moral obligation to do what I can to help those people.

Then there are those who can't get insurance because of what we call "Pre-Existing Conditions". Insurance companies won't cover them because to do so would threaten their entire block of business. I would be happy to explain this further if anyone is truly looking for an explanation, but for now I'll leave it right there. Some of these people are the ones I talked about in the first paragraph. They were initially out of the system by choice, and now they cannot get in. However, others may have lost their coverage because of a job change or similar circumstance. These, too, I feel need assistance and as it is impossible to sort out who may be deserving and who may not be, we'll have to err on the side of including them all.

To cover these people, there is going to be a cost. Perhaps a portion of the cost could be borne by the individuals themselves, if they have the means. However, the bulk of the cost will have to be picked up by the taxpayer.

Meanwhile, for those with insurance, costs keep going higher and higher. I keep thinking that they can't continue to increase forever, but except for a few years in the late 90's (if memory serves correctly) they have certainly been rising for my entire adult life. This too needs to be addressed, and the means of addressing it may very well be a fundamental change in the current system. We may in fact need to turn the system on end and build a new one from the ground up.